Medication Relatedness Determinations and Hospice Formularies: Understanding the Essentials
Hours: 0.75
The percentage of Medicare hospice beneficiaries billing Medicare Part D for one or more maintenance drugs was 71.3% in 2013, dropped to 50.8% in 2014 and made an unanticipated rise the subsequent year to 62.7%. To address this increase, CMS is analyzing how maintenance drugs are incorporated into hospice care plans and why these drugs are ‘not being coordinated and paid for by hospice beneficiaries’. CMS maintains that virtually all medications should be covered under the hospice benefit and it is the rare instance that Medicare Part D is billed for medications. At the end of this course, the attendee will recall the recommendation that hospice reports all diagnoses, whether related or unrelated to the terminal prognosis, including mental health disorders and conditions that would affect the plan of care. In addition, hospice covers all related and helpful medication therapy and documents rationale for medication non-coverage determinations.
The percentage of Medicare hospice beneficiaries billing Medicare Part D for one or more maintenance drugs was 71.3% in 2013, dropped to 50.8% in 2014 and made an unanticipated rise the subsequent year to 62.7%. To address this increase, CMS is analyzing how maintenance drugs are incorporated into hospice care plans and why these drugs are ‘not being coordinated and paid for by hospice beneficiaries’. CMS maintains that virtually all medications should be covered under the hospice benefit and it is the rare instance that Medicare Part D is billed for medications. At the end of this course, the attendee will recall the recommendation that hospice reports all diagnoses, whether related or unrelated to the terminal prognosis, including mental health disorders and conditions that would affect the plan of care. In addition, hospice covers all related and helpful medication therapy and documents rationale for medication non-coverage determinations.
